重复输血患者临床Rh表型血清学研究及同型输血必要性研究  

Serological study of clinical Rh phenotype and necessity research of homotransfusion in patients with repeated transfusion

作　　者：陈真 张继荣 Chen Zhen;Zhang Jirong(Department of Blood Transfusion,the People's Hospital of Pingyi County,Linyi 273300,Shandong,China)

机构地区：[1]平邑县人民医院输血科,山东临沂273300

出　　处：《实用检验医师杂志》2023年第4期347-350,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的分析临沂市平邑县人群Rh血清表型的分布情况,评估Rh 5种抗原检测在精准化同型输血中的必要性,从而为临床安全输血提供更多参考依据。方法选择2020年1月—2023年3月临沂市平邑县4710名献血者和5417名用血者作为研究对象。检测献血者和用血者的ABO血型分类及Rh血型系统分型抗原分类,分析发生不良反应事件和产生不规则抗体的情况,以及Rh分型抗原与不规则抗体的相关性。结果(1)ABO血型占比:献血者中A型占30.53%,B型占28.48%,O型占32.24%,AB型占8.75%;用血者中A型占31.42%,B型占25.63%,O型占34.56%,AB型占8.32%。(2)献血者中Rh分型抗原CCDee表型是最常见的类型,用血者与其一致。(3)2020—2023年用血者发生输血后不良反应的比例呈逐年下降趋势,抗E抗体比例亦呈下降趋势,不规则抗体的阳性率呈上升趋势,但逐渐趋于平稳。(4)用血者的Rh分型抗原阳性率与Rh抗体检测阳性率、Rh抗体检测阳性率与抗E抗体检测阳性率、Rh分型抗原阳性率与不规则抗体检测阳性率均不存在相关性(r值分别为0.875、0.900、0.700,P值分别为0.067、0.083、0.233)。结论Rh血型的5种分型抗原进行同型输血可以有效提高输血疗效、减少输血后血型特异性抗体的产生和降低不良反应的发生率,值得在临床推广。Objective To analyze the distribution of Rh serum phenotype in Pingyi County of Linyi City,and evaluate the necessity of detection of five Rh antigens in accurate homologous transfusion,in order to provide more evidence for the safety of clinical blood transfusion.Methods The 4710 blood donors and 5417 blood users in Pingyi County,Linyi City from January 2020 to March 2023 were selected as research subjects.The ABO blood type classification and Rh blood type system antigen classification of blood donors and users were detected,and the occurrence of adverse reaction events,production of irregular antibodies,and relationship between Rh typing antigens and irregular antibodies were analyzed.Results①The proportions of ABO type in blood donors were as follows:A type accounted for 30.53%,B type for 28.48%,O type for 32.24%,AB type for 8.75%;blood users:A type for 31.42%,B type for 25.63%,O type for 34.56%,AB type for 8.32%.②The Rh typing antigen CCDee phenotype was the most common type in blood donors,same as that in blood users.③From 2020 to 2023,the proportion of adverse reactions after transfusion in blood users showed a decreasing trend year by year,while the irregular antibody content showed an increasing trend,and the anti-E antibody showed a decreasing trend.④There were no correlations between the positive rate of Rh typing antigen and Rh antibody detection,Rh antibody detection and anti-E antibody detection,and Rh typing antigen positive rate and irregular antibody detection in blood users(r values were 0.875,0.900 and 0.700,and P values were 0.067,0.083 and 0.233,respectively).Conclusion Homologous transfusion of five Rh antigens could effectively improve transfusion efficacy,reduce the production of blood group specific antibodies,and reduce the incidence of adverse reactions,which is worthy of clinical promotion.

关 键 词：交叉配血 Rh分型抗原 不规则抗体 抗E抗体 

分 类 号：R457.1[医药卫生—治疗学] R446.6[医药卫生—临床医学]